Individual provider · Type 1 NPI

Jennifer Casilla

Adult Health Nurse Practitioner · Mastic, NY

NPI number 1679128904 Active

Practice location

1450 Montauk Hwy
Mastic, NY 11950-5528

Call (934) 248-5458 Map

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200XF309348-01 (NY)

Adult Health Nurse Practitioner: Definition to come...

About NPI 1679128904

Jennifer Casilla's National Provider Identifier is 1679128904, issued on Aug 4, 2019. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Mastic, NY. The record was last updated on Sep 29, 2026.